MEDICARE: YOUNG SUN YI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	A32144	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043366818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOUNG SUN YI

Provider Business Mailing Address
First Line	:	3000 W OLYMPIC BLVD
Second Line	:	200
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2567
Country	:	US
Telephone Number	:	213-385-4545
Fax Number	:	213-385-0450

Provider Business Practice Location Address
First Line	:	3000 W OLYMPIC BLVD
Second Line	:	STE 200
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-2516
Country	:	US
Telephone Number	:	213-385-4545
Fax Number	:	213-385-0450

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	01/10/2011

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Directions to “ YOUNG SUN YI ” Practice Location

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